Pulse generation systems are known from various medical applications, inter alia from neurostimulation applications and from pacemakers.
Also, such pulse generation systems are used in systems to deliver adaptive electrical spinal cord stimulation to facilitate and restore locomotion after neuromotor impairment as e.g. described in EP 2 868 343 A1.
U.S. Pat. No. 7,813,809 B2 describes an implantable pulse generator for prosthetic or therapeutic stimulation of muscles, nerves, or central nervous system tissue, or any combination is sized and configured to be implanted in subcutaneous tissue. The implantable pulse generator includes a case and a control circuitry located within the case, and includes a primary cell or rechargeable power source, a receive coil for receiving an RF magnetic field to recharge the rechargeable power source, non-inductive wireless telemetry circuitry, and a microcontroller for control of the implantable pulse generator.
U.S. Pat. No. 6,188,927 B1 discloses an implantable cardiac stimulation system, which automatically optimizes its ability to rate-responsively pace by enabling calibration when the patient is at rest and has a functioning lead. Devices, which employ physiologic sensors, are based on a baseline value of the sensor signal corresponding to the resting state. Accordingly, the control system determines if the patient is at rest using a suitable sensor and also determines if the lead impedance is within normal values, i.e. functional and intact. If these conditions are met, the control system stores the current baseline of the sensor at rest and proceeds with normal sensing and stimulation commands until the next calibration is performed. In addition, the system can automatically calibrate a sleep value for the physiologic sensor using a sensor which can detect the sleep state. While the preferred embodiment discloses a minute ventilation sensor, other closed-loop sensors are contemplated, including at least paced depolarization integral (PDI), QT interval and pre-ejection interval (PEP).
Furthermore, U.S. Pat. No. 5,571,141 describes implantable automatic cardioverter/defibrillator device for a cardiac patient has a primary control mode for a defibrillation therapy delivery system. The primary control mode is responsive to detection of fibrillation of the patient's heart for causing the delivery of a preselected electrical waveform therapy to the heart. The device also has a secondary control mode, which is enabled by detecting a predetermined failure mechanism that causes malfunctioning of the primary mode. The enabled secondary control mode uses at least some of the functional part of the primary mode in responding to fibrillation of the patient's heart to initiate generation of defibrillation therapy for application to the patient's heart.
In Wenger et al., spatiotemporal neuromodulation therapies engaging muscles synergies improve motor control after spinal cord injury, in: nature medicine, advanced online publication, published online Jan. 18, 2016, electrical neuromodulation of lumbar segments improvement of motor control after spinal cord injury in animal models and humans is described.
Furthermore, Wenger et al., Closed-loop neuromodulation of spinal sensorimotor circuits controls refined locomotion after complete spinal cord injury, in: www.ScienceTranslationalMedicine.org, Vol. 6, issue 255ra133 (2014), closing the loop on neuro prosthetic control, describes a closed-loop neuromodulation system of spinal sensory motor circuits.
It is an object of the present disclosure to provide a pulse generating system, which provides enhanced functionality, especially in that different operation modes can be provided, for example in the field of neurostimulation, here e.g. the field of stimulation of the spinal cord and especially in the field of recovery after neurological disorders and/or trauma.
The above object is obtained according to the present disclosure by, in one example, a pulse generating system including a pulse generator adapted to generate a pulse or pulses; and a controller adapted to control the implantable pulse generator, wherein the pulse generating system is adapted to operate in at least a regular mode and a safety mode, wherein in the regular mode the pulse generator and the controller are connected and wherein in the safety mode there is no or limited connection between the pulse generator and the controller and wherein in the safety mode the pulse generator automatically switches to a baseline stimulation command.
It should be understood that the summary above is provided to introduce in simplified form a selection of concepts that are further described in the detailed description. It is not meant to identify key or essential features of the claimed subject matter, the scope of which is defined uniquely by the claims that follow the detailed description. Furthermore, the claimed subject matter is not limited to implementations that solve any disadvantages noted above or in any part of this disclosure.